Suspended sediment is a natural component of rivers, but extreme suspended sediment concentrations (SSCs) can have negative impacts on water use and aquatic ecosystems. We identify the main factors influencing the spatial and temporal variability of annual SSC regimes and extreme SSC events. Our analysis shows that different processes are more important for annual SSC regimes than for extreme events and that compound events driven by glacial melt and high-intensity rainfall led to the highest SSCs.